Ocular ergotamine tartrate toxicity during treatment of Vacor-induced orthostatic hypotension.
A 20-year-old woman developed severe orthostatic hypotension after attempting suicide by ingesting the rodenticide, Vacor. Oral ergotamine tartrate, 6 mg a day, was useful in treating the orthostatic hypotension. However, a bilateral toxic retinal vasculopathy, consisting of a severe generalized vasoconstriction and mild macular edema, occurred within three weeks. Additional findings were an extinguished electroretinogram and a reduced dark-adaptation retinal sensitivity; because we performed these two tests after instituting ergotamine therapy we do not know whether to attribute their abnormal results to Vacor toxicity, ergotamine toxicity, or a combination of the two.
D000328:Adult; D003623:Dark Adaptation / Q000187:drug effects; D004596:Electroretinography; D004878:Ergotamine; D004879:Ergotamines / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007024:Hypotension, Orthostatic / Q000139:chemically induced* / Q000188:drug therapy; D010671:Phenylurea Compounds / Q000506:poisoning*; D012171:Retinal Vessels / Q000187:drug effects; D012378:Rodenticides / Q000506:poisoning*; D014786:Vision Disorders / Q000139:chemically induced*
D004879:Ergotamines; D010671:Phenylurea Compounds; D012378:Rodenticides; D004878:Ergotamine; C012598:pyriminil